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Saturday, March 9, 2013

ANNIE'S CANCER SURGERY

Quite a while ago I promised to write about Annie's surgery once I could bring myself to do so. Now is the time.

As anyone following this blog will know, Annie had a lump at the bottom of her rib-cage for more than a year. Both myself and Artie as well as Annie's doctors were monitoring it. The lump felt like a fatty tumor. At the time of Buddy's death, Artie wanted to have it removed; I did not want to put her through surgery if it wasn't necessary because of her age as well as the dangers associated with surgery and anesthesia. We decided to continue to monitor the lump.

Around Thanksgiving we noticed the lump was bigger. Not by much but now we were concerned with 'quality-of-life' issues - would it be uncomfortable for her to lie on her side? If we didn't remove it now and it became bigger wouldn't surgery be riskier as she aged?

Annie went for an office visit December 13th. We discussed our concerns with the doctor and a sample was taken. When the cytology report came in December 15th, the findings were as follows:

"No significant inflammatory response was evident. The spindle cells displayed minimal atypia. Findings may reflect a benign fibrosing cystic structure, cystic spindle cell tumor (fibroma or low grade malignant potential sarcoma), or other underlying nonexfoliating fibrosing cystic structure."

At that point the both of us AND the doctor wanted it removed. Surgery was performed December 20th; Annie came home the same day. She was still somewhat under the effects of the anesthesia, on Rimadyl, not interested in food or water and did nothing but sleep. It took a few days for Annie to return to her usual self - a sure sign that my girl is older now.

Christmas was a somber affair as we worried about the biopsy results. The results of the biopsy came December 26th and the lump definitely was cancer. The report characterized it as a slow-moving soft tissue sarcoma. The surgery did not produce clear margins; Annie needed to have additional surgery. If the second surgery did not produce clean margins, she would need radiation therapy. We were referred to Dr. Cohen at VERG (Veterinary Emergency Referral Group) and an appointment was made for the next day.

Early the next day, Artie and I took Annie for her consult with the oncologist. Dr. Cohen was wonderful and Annie fell in love with her. After the exam, Annie was taken for a series of x-rays while we waited in the examining room.

Dr. Cohen returned with the x-rays and reviewed them with us. Annie had several points in her favor.
  1. Her behavior was normal which Dr. Cohen assured us was a good sign.
  2. There were no visible tumors on any of the x-rays - a good indicator that the tumor most likely wasn't metastatic.
  3. Radiation would only be needed if the second surgery did not produce clean margins.
  4. Annie had a good chance of a 100% recovery if the second surgery produced clean margins.
We discussed radiation therapy which would be done over a period of eighteen days if needed. My mind was reeling from the logistics.  There were 3 places Annie could go to, the Animal Medical Center in NYC, a facility upstate or a facility in New Jersey. She would go on an outpatient basis which meant going in and coming home daily or she could stay for 5 days coming home for the weekends. Dr. Cohen suggested not thinking about next steps until we had the post-surgery results. The follow-up surgery was scheduled for January 5th and we all went home to wonder what 2013 had in store for Annie health-wise.

I will pick up this narrative in a second post along with post-surgery photos.



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